=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629109921
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARI ANN MARZOLF MA CCCA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/08/2007
-----------------------------------------------------
Last Update Date | 06/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 S STATE ST STE 1
-----------------------------------------------------
City | ZEELAND
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49464-1677
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-772-1986
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 S STATE ST STE 1
-----------------------------------------------------
City | ZEELAND
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49464-1677
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-772-1986
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 1601000182
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------